Individual
FREDRICK KOLLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1615 KENILWORTH AVE NE, WASHINGTON, DC 20019-2010
(202) 588-8036
(202) 588-8038
Mailing address
1615 KENILWORTH AVE NE, WASHINGTON, DC 20019-2010
(202) 588-8036
(202) 588-8038
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
A00187288
MD
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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